Afghanistan: Humanitarian groups need $406 million in 2014

Helmand Province, Afghanistan: The emergency room at the Boost Hospital in Lashkar Gah, Helmand province, southern Afghanistan. Just under 3,000 civilians were killed in the conflict in 2013 - a 17 per cent increase on 2012. Credit: MSF/Mikhail Galustov

The United Nations and its humanitarian partners are seeking US$406 million to provide five million people with essential, life-saving aid in 2014.

At an event to launch the 2014 Common Humanitarian Action Plan (CHAP) held in Kabul in early February, Afghanistan’s Minister of Rural Rehabilitation and Development, Wais Barmak, said the government and international community hoped to build on progress made in 2013.

“Last year, significant achievements were made,” he said. “For example, food assistance was delivered to 2.2 million Afghans, shelter and non-food items were provided to more than 140,000 displaced people, [and] 570,000 people received emergency water, sanitation and hygiene” he said.

A protracted complex emergency

Despite more than a decade of international assistance, Afghanistan remains in a protracted complex emergency, where an unresolved conflict continues to undermine and prevent efforts to tackle chronic under development.

The latest National Risk and Vulnerability Assessment conducted by humanitarian groups, shows stagnation and deterioration in both food security and poverty. About 30 per cent of the population are food insecure and more than one third live below the poverty line.

A worsening impact of the conflict on civilians

A recent report by the UN Assistance Mission in Afghanistan (UNAMA) documented more than 8,615 civilian casualties - including almost 2,959 deaths - in 2013. This represents a 7 per cent increase in civilian deaths, a 17 per cent increase in injuries, and a 14 per cent increase in total civilian casualties compared to 2012.

More than 630,000 people are considered conflict displaced, with continued fighting driving at least 124,000 Afghans from their homes in 2013, a 25 per cent increase from 2012.

Health the top priority in 2014

Creating access to health care is perhaps the most pressing priority for aid groups. In 2013, the number of people in need of access to emergency healthcare increased from 3.3 to 5.4 million, as conflict disrupted the delivery of basic health services.

According to a recent report by the NGO Médecins Sans Frontières (MSF), access to basic and emergency medical care in Afghanistan is severely limited and ill-equipped to meet the growing needs created by the conflict.

The report’s research – conducted in 2013 with more than 800 patients in MSF hospitals in Helmand, Kabul, Khost and Kunduz– paints a bleak picture of the suffering of Afghans who struggle without access to adequate medical assistance.

“One in every five of the patients we interviewed had a family member or close friend who had died within the last year due to a lack of access to medical care”, said Christopher Stokes, MSF’s General Director. “For those who reached our hospitals, 40 per cent of them told us they faced fighting, landmines, checkpoints or harassment on their journey.”

Targeted funding helps to save lives

This analysis is reflected in the 2014 CHAP. Health and nutrition-focused aid groups have appealed for $65 million in order to reduce conflict-related deaths, injuries and illness, as well as to restore or establish emergency health care. Funding will go to groups like Emergency, an Italian NGO that has been providing trauma care for the past 15 years. The group has a network of three surgical centres and 30 first aid posts spread across the country.

“Fortunately the international community has [started to] seriously address the issue of trauma care,” said Emanuele Nannini, project coordinator for Emergency. “The prioritization of trauma care in the 2014 CHAP is commendable and will seriously help to mobilize adequate resources” he said.

In 2013, a $690,000 grant from the OCHA-managed Emergency Response Fund (ERF) helped Emergency treat 5,000 people at their surgical centres in the capital Kabul and Lashkargah in southern Afghanistan. More than 80 per cent of these cases were war-related injuries, and the mortality rate of their patients was just 4 per cent.

In insecure provinces like Hilmand, Logar and Paktia, Emergency was able to stabilize more than 1,600 war related patients in their first aid posts in 2013, before transferring them by ambulance to their surgical centres.

A call for continued funding in 2014

The $406 million that aid groups are calling for in 2014 represents a decrease of 20 per cent compared with 2013.

“The 2013 appeal was 80 per cent funded, which was very encouraging,” said the UN Humanitarian Coordinator for Afghanistan, Mark Bowden. “If donors simply repeat their contributions this year, then we could see an almost fully funded humanitarian community in 2014.”

*MSF relies only on private funding for its work in Afghanistan, and does not accept money from any governments, or pooled funds like the CHAP.